Вестник трансплантологии и искусственных органов (Jun 2018)

HEART TRANSPLANTATION FROM DONORS WITH LEFT VENTRICULAR EJECTION FRACTION <40%

  • V. N. Poptsov,
  • V. M. Zakharevich,
  • E. A. Spirina,
  • V. M. Khatutskii,
  • N. N. Koloskova,
  • I. Yu. Tunyaeva,
  • V. V. Pchelnikov,
  • S. Yu. Ustin,
  • S. A. Masyutin,
  • V. Yu. Voronkov,
  • A. A. Dogonascheva,
  • E. Z. Aliev

DOI
https://doi.org/10.15825/1995-1191-2018-2-29-36
Journal volume & issue
Vol. 20, no. 2
pp. 29 – 36

Abstract

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Aim. Purpose of study was evaluated of early outcomes of HT performed from donors with LVEF <40%.Materials and methods. The study included 18 (14 men and 4 women, age 29 to 59 (42.9 ± 2.7) years) recipients who received cardiac allograft from donors with LVEF <40%. The urgency of HT was 1A-B (n = 16) and 2 status (n = 2) UNOS. 11 (55,6%) patients needed peripheral VA ECMO.Results. Heart donors (13 men and 5 women, 22 to 57 (39.1 ± 3) years) were the traumatic (n = 3) and non-traumatic (n = 15) brain damage. Maximal inotropic support was norepinephrine 433 ± 46.2 ng/kg /min (n = 14) and dopamine 5.6 ± 2.5 μg/kg/min (n = 4). Laboratory parameters of the heart donor blood: Hb 11.5 ± 0.7 g/l, total protein 72 ± 14 g/l, Na+ 139 ± 3 mmol/l, troponin I 0.3 ± 0.2 ng/ml, CK-MB 98 ± 18 U/l. ECG of the donor’s heart: LVEDV 134 ± 9 ml, LVEF 22–39 (35.3 ± 4.3)%, diffuse LV hypokinesis (n = 10), regional dyskinesis (n = 8). Ischemic time was 151 ± 27 min. 16 (88.9%) had acceptable cardiac allograft function. Primary graft failure treated by MCS (VAECMO (n = 2)) was in 2 (11.1%). ICU stay was 7.7 ± 1.2 days. All recipients were discharged at home.Conclusions. Own experience demonstrates the satisfactory results of HT from donors with LVEF <40%. In more cases LV systolic function of cardiac allograft quickly normalized in early period after HT.

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